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Individual

JENNIFER JOAN WILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.P.T.

Contact information

Practice address
3744 S TIMBERLINE RD, SUITE 103, FORT COLLINS, CO 80525-4333
(970) 204-4263
Mailing address
3744 S TIMBERLINE RD, SUITE 103, FORT COLLINS, CO 80525-4333
(970) 204-4263

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5202
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71489738
CO
Enumeration date
10/28/2006
Last updated
03/03/2008
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